title: Muscle-chimaeric medial sural artery perforator flap: a new design for complex three-dimensional knee defect.
abstract: Reconstructions of composite and three-dimensional knee defects remain challenging. Gastrocnemius musculocutaneous flaps have been widely used for complex knee-defect reconstruction, but problems of donor-site morbidity and bulkiness of flaps remain. In the present study, we designed a new muscle-chimaeric medial sural artery perforator flap and applied the technique in a clinical case. A gastrocnemius muscle segment with sufficient pedicle length was obtained by intramuscular dissection of the vascular pedicle. The muscle segment was then utilised to fill the underlying dead space and the remaining soft tissue and skin defects were reconstructed with the perforator skin flap. The flap survived completely and wound healing progressed smoothly without infection, haematoma or seroma. Our patients were satisfied with their aesthetic outcomes and did not experience any donor-site morbidity. The muscle-chimaeric medial sural artery perforator flap is a valuable option for the reconstruction of composite and three-dimensional knee defects.
authors.affiliation: Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: So-Eun
authors.initials: SE
authors.lastname: Han
authors.affiliation: Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Kyeong-Tae
authors.initials: KT
authors.lastname: Lee
authors.affiliation: Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. Electronic address: supramicro@gmail.com.
authors.forename: Goo-Hyun
authors.initials: GH
authors.lastname: Mun
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007717:Knee / Q000473:pathology / Q000601:surgery*; D018482:Muscle, Skeletal / Q000637:transplantation; D020370:Osteoarthritis, Knee / Q000601:surgery; D061525:Perforator Flap / Q000098:blood supply*; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000601:surgery*; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000601:surgery*; D013530:Surgical Wound Infection / Q000209:etiology / Q000601:surgery*; D014947:Wounds and Injuries / Q000209:etiology / Q000601:surgery
keywords: Chimaeric flap; Flap design; Knee reconstruction; Medial sural artery perforator flap